吉非替尼治疗晚期非小细胞肺癌的疗效观察

Therapeutic effect of gefitinib in patients with later period non-small cell lung cancer

目的分析吉非替尼和培美曲塞治疗晚期非小细胞肺癌(NSCLC)的临床疗效。方法选取2011年1月—2013年12月收治的Ⅲb~Ⅳ期NSCLC患者共120例,按随机数字表法分为吉非替尼组和培美曲塞组各60例。吉非替尼组予以吉非替尼250 mg口服,每天1次,培美曲塞组予以500 mg/m^2静脉给药。2组患者治疗前后进行体力状况评分(PS)和国际生存质量肺癌治疗状态评价量表(FACT-L)评分。对比2组患者的近期疗效、治疗后生存情况和严重不良反应发生率。结果 2组患者治疗前后PS评分差异均无统计学意义(P>0.05)。与治疗前比较,2组患者治疗后的FACT-L评分中情感状况、躯体状况、社会/家庭情况、功能状况和肺癌特异模块均显著升高(P<0.05);且吉非替尼组上述指标均显著高于培美曲塞组(P<0.05)。吉非替尼组治疗后近期疗效显著优于培美曲塞组(31.66%vs.11.67%,χ~2=7.070,P<0.01)。吉非替尼组的中位治疗周期数、中位总生存期(OS)、6个月生存率、1年生存率、中位无进展生存期(PFS)和6个月PFS率显著高于培美曲塞组(P<0.05)。吉非替尼组治疗后的严重不良反应发生率为13.3%(3/60),显著低于培美曲塞组的31.7%(19/60),差异有统计学意义(χ~2=5.783,P<0.05)。结论吉非替尼治疗晚期NSCLC的临床疗效和生存率优于培美曲塞,同时不良反应发生率低,适合临床作为二线化疗方案应用。

Objective To analyze the therapeutic effect of gefitinib and pemetrexed in the treatment of advanced non- small cell lung cancer （NSCLC）. Methods From January 2011 to December 2013, a total of 120 cases of stage IIIb-IV NSCLC patients were enrolled, according to the random number table method, they were divided into gefitinib and pemetrexed group With 60 cases in each group. Gefitinib group received gefitinib 250 mg orally, once a day, pemetrexed group received intravenous administration of 500 mg/m2. The physical status score （PS） and the international quality of life evaluation of the lung cancer treatment volume table （FACT-L） score in two groups of patients before and after treatment were compared. The short-term effect, the survival and the incidence of severe adverse reactions were compared between the 2 groups. Results PS score differences before and after treatment between the 2 groups did not show statistically significant （ P 〉 0.05 ）. Compared with before treatment, after treatment, patients in the two groups＇ FACT L score included emotional status, physical condi- tion, social / family situation, functional status and lung cancer specific module were significantly increased （ P 〈 0.05 ） ; and gefitinib group＇ s parameters were significantly higher than those of pemetrexed group （ P 〈 0.05 ）. Gefitinib group after treatment＇ s near efficacy was significantly better than the pemetrexed group （31.66% vs. 11.67% ,χ^2 = 7. 070, P 〈 0.01 ）. Gefitinib group＇ s median number of treatment cycles, the overall survival （OS） , 6 months survival rate, 1 year survival rate, median progression free survival period （ PFS ） and 6 month PFS rate is significantly higher than that of pemetrexed group （P 〈 0.05 ）. Gefitinib group＇ s serious adverse reaction incidence was 13.3% （3/60）, which was significantly lower than that of＇ pemetrexed group＇ s 31.7 % （ 19/60）, the difference was statistically significant （ χ^2 = 5. 783, P 〈 0.05 ）. Conclusion Gefitinib＇ s clinical efficacy and survival rate for treatment of advanced NSCLC is better than that of pemetrexed, and ad- verse reaction rate is low. It is suitable for clinical used as second-line chemotherapy.